• Kevin A Hallgren, Richard K Ries, David C Atkins, Kristin Bumgardner, and Peter Roy-Byrne.
• From the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle. khallgre@uw.edu.
• J Am Board Fam Med. 2017 Mar 1; 30 (2): 150160150-160.

BackgroundSuicide is a major public health concern, particularly among people who use illicit substances and/or non-prescribed medications.MethodsThe present study prospectively assessed the incidence and predictors of suicidal ideation (SI) and suicide attempt (SA) among 868 substance-using patients over 12 months after receiving primary care within seven public primary care clinics.ResultsParticipants reported a high incidence of SI (25.9%) and SA (7.1%) over the year following primary care visits. Suicidality was elevated in patients who were female; lacked a high school diploma; were unemployed; reported depression, anxiety, hallucinations, concentration difficulty, or violent behavior; used nicotine or stimulants; used the emergency department or mental health services in the past 90 days; reported current quality-of-life impairment in mobility or usual activities; or reported recent SI or lifetime SA at baseline. In multiple regression analyses, only past 30-day SI, any lifetime SA, past 90-day violent behavior, and current impairment due to anxiety or depression at baseline uniquely predicted SI or SA beyond other variables.ConclusionsResults support the need for screening for suicidality among primary care patients who use illicit substances and identify key of these patients who are at particularly elevated risk for suicidality.© Copyright 2017 by the American Board of Family Medicine.

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